Prenatal Substance Use and Mental Health Comorbidities Predict Continued Use

Objective: Prenatal substance use is common and can affect maternal and infant health. In addition, prenatal substance use is associated with mental health comorbidities (depression, anxiety, and posttraumatic stress disorder). Unremitting prenatal substance use disorders and mental health comorbidities are associated with poor health outcomes for mothers and exposed infants. The purpose of this study was to examine how any substance use, type of substance use (polysubstance use vs. single substance use), and combinations of mental health comorbidities predict continued use during pregnancy (i.e., use in the 30 days prior to delivery). Method: Health records of patients enrolled in a comprehensive prenatal program for women with substance use disorders were retrospectively analyzed (N = 281). Urine drug screen records were used to determine substance use, and diagnostic codes were used to identify mental health comorbidities. Results: Thirty-seven percent of the sample (n = 105/281) tested positive for substances at admission and 42% (n = 119/281) demonstrated continued use. 30% of the sample (n = 85/281) had depression, anxiety, and posttraumatic stress disorder, 27% (n = 76/281) had two of the three mental health comorbidities, 26% (n = 73/281) had one of the three comorbidities, and 17% (n = 47/281) did not have a mental health comorbidity. Any substance use at admission or having all three mental health conditions were associated with continued use. Conclusions: Substance use at admission and number of mental health conditions were independent predictors of continued use, although substance use was the stronger predictor.